Unit Manger Presence

I work in a manager position. If I worked every time we were short or someone called out sick, I might as well just work as a floor nurse.

I will add, I don't let the nurses drown, I do help out all the time when they are overwhelmed but as far as actually working a scheduled shift, no. I couldn't do MY job if I did that.

I work in critical care, so we are always staffed fully.

But for the last two years we have been without a unit manager. Managers from other units fill in, or the director fills in.

It doesn't seem to have hurt us.

It doesn't happen often but I have seen my Nurse Manager work on the floor. She even did a shift as a night shift aide! She is the first one to admit that her skills are rusty and she wouldn't be the first one I call in on a code but she is awesome at keeping all the administrative junk to a minimum and that's pretty terrific in my book!

This is such a sore spot on our unit. Not only would our NM NEVER think of even answering the phone when we are drowning, but she adds to the chaos by calling us out of the room to sign off education papers, etc. One time I had an isolation patient and had just completely put my gown, gloves and mask on and entered the room. She called for me from outside the patient's door. Although I had told her I JUST had entered the room, she insisted I step out. I thought it was really important. She wanted me to sign off on staff meeting minutes!

This is such a sore spot on our unit. Not only would our NM NEVER think of even answering the phone when we are drowning, but she adds to the chaos by calling us out of the room to sign off education papers, etc. One time I had an isolation patient and had just completely put my gown, gloves and mask on and entered the room. She called for me from outside the patient's door. Although I had told her I JUST had entered the room, she insisted I step out. I thought it was really important. She wanted me to sign off on staff meeting minutes!

The job of the manager is not to be at the bedside staffing the unit on a regular basis when the unit is short a nurse.

Their responsibility lies in running the unit 24/7/365 in an administrative role but not in a clinical role. Managing a unit EFFECTIVELY (that's a key word!) takes a lot more work in the background that what a lot of bedside folks see. There are constant meetings that MUST be attended, e-mails that must be answered, budget issues, supply issues, hiring, firing, training, interviewing, dealing with problem staff, working with other unit directors to get issues resolved, regulatory readiness issues, and ensuring that their staff have adequate supplies and equipment so that they can carry out their duties.

When the unit is short, the manager should be on the phone calling the other staff members to see if they will pick up, posting the shifts to other units (within the same level of care), and then calling the agency to see if you can get a staff member. Another issue is making sure that the manager stays up with where the holes already are and not to wait until 4 hours before the shift starts to begin calling folks. It needs to be kept up with a few days in advance so that people can rearrange (some people will actually do this!) their schedules so that they can fill in the shifts.

All that being said.....very few managers are effective at their role AND at the same time viewed as effective by their staff.

Yes, nursing is 24/7 but the nurse manager cannot work 24 hours a day.

I've been in a management position...if I went in everytime they were short I'd have worked 24 hours a day. It is up to the institution to find a solution to chronic shorteness. I am the same as others with the same labor laws...I have to have 8 hours off between shifts and I can't work over 16 hours. Why should it be different for me than for you? I would make calls, etc, but I can't force people to work...talk to your co-workers who never,ever stay to help...I would stay and pitch in when I could, but you need to also rely on your peers. Running a unit is hard...there is so much on the other side that you don't see. And you also have to realize that when I ***** at you about something, most likely I got ******* at by the higher ups about the same thing. Put yourself in our shoes for a moment. Our manager now will pitch in and help and she has come in at 3am to help. She is always available by phone if we need her.

A nurse manager dont have to take a patient load every time. They can do accuchecks, pass meds, take off orders, and do admissions and discharges. These duties are a big help to any nurses. If you dont help or feel you dont have to the work. How a nurse manager expect her nursing staff to do it? Down the road the unit would not have any nurses. The nurses are going to go somewhere else. Most Telemetry units have a high turnover rate. The nurses do their 1 year of nursing and move onto something else. I have worked a tele unit as a nurse over 3 years and I believe I need to do something different to grow.

I don't expect her to work regulary scheduled shifts-at all. I would expect her to show up on night shift, which she has never done - ever. This includes her time as a nurse on the floor. How can you be an effective manager if you manage by word of mouth for over half of your employees.